There were some questions posted about medications for osteoporosis during
bfg.  The full version of the following articles give a lot of food for
thought, and discusses some drugs being used including alendronate.

Michelle Bentley, CLE

BMJ 2002;324:886-891 ( 13 April )

http://bmj.com/cgi/content/full/324/7342/886
    Selling sickness: the pharmaceutical industry and disease mongering
    Commentary: Medicalisation of risk factors

Risks conceptualised as diseases: osteoporosis

"Like high blood pressure or raised cholesterol levels, the medicalisation
of reduced bone masswhich occurs as people age is an example of a risk
factor being conceptualised as a disease.

Unlike medicalising baldness, conceiving osteoporosis as a disease is
ethically complex. Slowing bone loss can reduce the risk of future fracture
just as lowering blood pressure can reduce a person's chance of a future
stroke or heart attackbut for most healthy people, the risks of serious
fractures are low and/or distant, and in absolute terms, long term
preventive drug treatment offers small reductions in risk...."

http://bmj.com/cgi/content/full/324/7342/908

Direct to consumer advertising is medicalising normal human experience

"Many advertising campaigns focus on fears of death or disability. In Better
Homes and Gardens (April 2000), Merck, manufacturer of alendronic acid, told
older US women, "See how beautiful 60 can look? See how invisible
osteoporosis can be?" The advertisement urges women aged 60 or older to go
for a bone density test, citing a nearly 1 in 2 chance of having
osteoporosis, leading to broken bones and dowager's hump"no matter how
healthy you look on the outside." Bone mineral density testing is a poor
predictor of future fractures5 but an excellent predictor of start of drug
use.6 For healthy people, benefits may not outweigh risks: in pre-marketing
trials 1.5% of users of alendronic acid experienced oesophageal ulcers.7 "

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